July 2011

Saturday, July 30, 2011

For those of you outside of their catchment area, Fry's is a chain of consumer electronics & etc. stores that specialize in low prices, ignorant but low-paid staff, and really crappy service.

I needed a small, cheap video camera, and on a whim, went into Fry's. I purchased a SD camcorder there earlier this month, on sale at a deep discount.

Here's how it works at Fry's : you select a make and model you want; the sales minion (who is often completely unknowlegeable about the product) writes up the sale and prints out a document like a purchase order; you take the document (or documents, should you purchase more than one item) to the cashier; you pay for the items and the cashier minion hands over the hard goods.

The SD Camcorder I bought and paid for was Mac OS compatible. The box I got had been previously opened, and resealed, but matched the documents -- that is, indicated the camera was Mac OS compatible. I've used the camera for two weeks.

It wasn't until today, when I tried to download the recorded videos, that I realized that the camera in the box was a different, non-Mac-OS compatible model of the same make.

I've had the camera more than 15 days, so it isn't returnable. The box has been opened, anyway, so there would be a 15% restocking fee. And the documentation doesn't match the actual camera in the box.

Fook.

So here's what I am going to do:

Somehow, get the data from the camera (about 30 minutes of images & some stills) off the camera and into a Mac-compatible format.

Find a teacher who needs a Microsoft video camera & give it to him or her

Buy another similar camera that is Mac-compatible from a reputable retailer

Never ever patronize Fry's again

Oh, and why do I feel stupid? I knew about Fry's lousy track record. I saw that the camera box had been sold, returned, and resealed. I just didn't bother to check that the camera in the box matched the sales receipt and the description on the box.

Saturday, July 16, 2011

note: Dr. Jay isn't very meticulous with his twitter etiquette. He often (always) fails to replace RT with a designation such as MT (indicating a modified tweet) or using a word like "asks" -- so the latter part, beginning with "To @epiren", is his response, not part of the original tweet

What is clear: this child continues to have severe and multiple challenges, relative to health, physical, and cognitive function. Not only has this girl -- now a teen--been suffering, her parents and other family members have been suffering as well. As for every family with such challenges, I am deeply sympathetic to this child's suffering and life limitations.

That does not mean I cannot or should not challenge any family member's narrative about the cause of those challenges.

What is important here: the author of the opinion piece is that girl's great-aunt, and has a specific view, not grounded in research or science, that vaccines may be causal in autism or may have more risks than benefits.

The mendaciousness starts with the headline, the deck, and the byline. (Keep in mind that the author of a given newpaper article isn't responsible for the headline or deck -- but is responsible -- for the most part -- for his or her bio.)

with the claim, "we don't know enough about childhood vaccines" and the vague assertion that the author is a "researcher".

Margaret Dunkle is a very accomplished woman, but not in the area of vaccinology or vaccine safety. She has a batchelor's degree in psychology, and appears to have spent the 1970s and 80s as an advocate for women's equality, especially in athletics. She also has an interest in gender equality in school health programs. Later, her professional focus turned to the coordination of services for children with disabilities, and establishing early developmental screenings for children -- especially low-income children -- who might be at risk for developmental delays.

While her faculty page lists her areas of expertise as

Civil Rights

Health Disparities

Public Policy

Vaccine Safety

I would say her accomplishments and publications make her an expert in vaccine safety in the same way I am an expert in vaccine safety.

The following is the text of Ms. Dunkle's opinion piece. Her article is indented, in italics. My comments are in roman; quotes from others are indented in roman.

The topics of vaccines and vaccine safety spark emotional outbursts at scientific meetings and family dinner tables alike. ....

I don't doubt that there are emotional intra-family discussions; I've had a few of them myself. But Dunkle is mistaken, or disingeneous, to allege "emotional outbursts" at scientific meetings. The topic of vaccines and autism risk has been studied at length, with dozens of studies with hundreds of thousands of subjects. No increased risk for autism has been associate with vaccines. The overall subject of the safety of the recommended pediatric vaccines -- especially compared with the risks from the diseases they protect against -- is likewise not a topic that raises much interest, let alone "outbursts".

But many of these debates are remarkably fact-free.

I highly doubt that discussions about vaccine safety in scientific meetings are "fact-free".

Surprisingly few people — not just concerned parents but also doctors, policymakers and even immunization experts — can answer this seemingly simple question: How many immunizations does the federal government recommend for every child during the first two years of life?

I am not sure of her point here. If you stopped the average pediatrician in the street, I doubt she would be able to answer the question off the top of her head. I usually have to look it up and count to make sure I am remembering correctly. Centers for Disease Control's recomendations are available in multiple formats to prompt the memory of of health care providers and parents. There's even an iPhone app for parents to help them keep to the schedule.

The answer is important because most states, including Maryland, faithfully follow the recommendations of the federal Centers for Disease Control and Prevention, codifying CDC guidelines into requirements for children to enroll in school, kindergarten, preschool and child care.

As if policy-makers can't be troubled to go to the CDC's website and print out any of many charts of the recommended vaccine schedules. Of course the states follow the CDC's recommendations -- they are formulated for the most public health.

A new Journal of Toxicology and Environmental Health study reports that the higher the proportion of infants and toddlers receiving recommended vaccines, the higher the state's rate of children diagnosed with autism or speech-language problems just a few years later. This analysis is sure to rekindle the debate about vaccine safety.

Oh my. The "study" Dunkle is referring to is the deeply flawed paper written by Gayle deLong, an attorney, whose two daughters have autism. A list of articles detailing the paper's flaws are at the bottom of this post. The short answer is that the paper is so flawed that many question how it even passed peer review and came to be published. The DeLong paper is so weak that it does nothing to "rekindle the debate", and Ms. Dunkle should know that.

For that conversation to produce useful results, we must start by defining terms. A "dose of vaccine" refers to each vaccine or antigen given to increase immunity against one specific disease. For chicken pox, a child receives one dose of vaccine through one shot.

By contrast, an "immunization event" refers to each separate administration of a vaccine or bundle of vaccines — through a shot, orally, or nasally. The MMR shot for mumps, measles and rubella involves three doses of vaccine but is one immunization event.

The critical number is how many doses of vaccine a child receives. Why? If a vaccine is strong enough to confer immunity against a disease, it is important enough to count separately.

This passage reveals either Dunkle's ignorance, her bias, or both. The critical issue is not "doses" or "immunization events" but the number of antigens a child is exposed to through vaccination. If you are unclear on this (and many lay people are) I highly recommend the resources at the History of Vaccines project, specifically How Vaccines Work.

Clear definitions, analysis of CDC's "General Recommendations on Immunization," and confirmation by Dr. Andrew Kroger, lead author of the definitive report on these recommendations, produce the answer to the not-so-simple-after-all question posed above.

In all, the federal government recommends 36 doses of vaccine, addressing 14 different diseases, for every U.S. child under age 2. An on-schedule child will receive a dose of vaccine for hepatitis B at birth, eight doses of various vaccines at 2 months, seven additional doses at 4 months, and four to seven more doses at 6 months.

Infants and toddlers receive these vaccine doses through 26 separate immunization events — mostly shots. If a child misses vaccinations because of illness or scheduling problems, following CDC's catch-up schedule usually results in extra doses at a later date.

The federally recommended doses of vaccine for every child during the first two years of life are: three doses each for hepatitis B, polio, flu, and HIB (12 doses in all); two doses each for hepatitis A and rotavirus; four doses for pneumococcal infections; one dose for chicken pox; three doses through the combination MMR vaccine for measles, mumps and rubella; and 12 doses through four separate administrations of the combination DTaP vaccine for diphtheria, tetanus and pertussis (whooping cough).

Put that way, it seems to be overwhelming. But why is the vaccine schedule the way it is? Readers might peruse The Infection Schedule versus the Vaccine Schedule, by infectous disease specialist Mark Crislip. Dunkle's argument is just a of the "too many, too soon" argument that has been refuted, over and over again.

How else could one state it? How about, "the federally-recommended vaccine schedule protects infants and toddlers from 14 serious illnesses. Prevention of these illnesses has demonstrably improved individual or public health."

Some infants and toddlers receive still more doses of vaccine — if they switch to pediatricians who use different "combined" vaccines, if they are at high risk for certain diseases, if lost or incomplete records lead to duplicate immunizations, and depending on the time of year they were born (for flu shots) or the brand of vaccine used.

While testing is routine for individual vaccines as they are licensed, research on the both short- and long-term effects of multiple doses of vaccine administered to very young children during the critical birth-to-2 developmental window is sparse to nonexistent.

In addition to the number of doses, vaccine ingredients can be problematic, especially for susceptible subgroups. First are adjuvants, substances added to boost effectiveness and allow smaller doses of vaccine antigen to be used. The most common adjuvant is aluminum, which is found in vaccines for hepatitis and diphtheria-pertussis-tetanus.

First -- Dunkle essays another foray into begging the question. What is the evidence for "susceptible subgroups"? Who are in those those subgroups, what are they susceptible to, and how do we know?

Second are preservatives — such as thimerosal, which is 49.6 percent mercury. Thimerosal is still contained in many flu shots, although it was, except for trace amounts, removed from other child vaccines a decade ago. Many child vaccines (including those for diphtheria-pertussis-tetanus, HIB, and hepatitis) contain formaldehyde, which was just added to the government's list of known human carcinogens.

Why bring up thimerosal, which has been removed from all vaccines except some flu shots? Why not mention that thimerosal-free flu vaccinations available? Because Dunkle's aim in this essay is to repeat the anti-vaccine message that there are unsafe ingredients in vaccines.

Then Dunkle emits another of the toxins!!! gambit -- formaldehyde. It certainly sounds vile -- it's used in embalming fluid, after all -- but she omits the fact that the body -- even babies' bodies--naturally produce formaldehyde at levels up to ten times the amount in a vaccine.

Third are ingredients to which some people have severe allergies: stabilizers such as gelatin, and eggs or other proteins that are used to prepare vaccines for flu, MMR, and other immunizations.

Dunkle is partially correct. "Some people" are allergic to eggs and gelatin, which limits their access to the protections provided by the vaccines that are grown in eggs, or use gelatin as a stabilizer. But first, the percentages are very small. About 0.5% of people are allergic to eggs, and a somewhat larger percentage are allergic to gelatin. But here's where Dunkle gives away her true identity: she isn't a "vaccine safety expert" (or advocate), she's merely a garden-variety anti-vaccinationist. A true vaccine safety advocate would be advocating for change in vaccine manufacture. It's possible to make vaccines without growth in eggs; it's possible to find other stabilizers than gelatin. The manufacturers (given the small size of the at-risk population) need to be goaded into making the changes.

The ongoing debate about vaccines and their safety needs to incorporate these basic facts as our country seeks to answer the critical Goldilocks question: Too many? Too few? Or just right?

"Needs to incorporate these basic facts". As I have indicated, many of Dunkle's facts...aren't factual. The points Dunkle failed to make are the reasons for the recommended CDC vaccine schedule: the protection of children (and adults) from serious infectious disease with high risks of adverse outcomes. Dunkle completely ignored the relative risks of infectious disease compared to vaccination.

The Baltimore Sun has in recent months done good work on exposing another set of anti-vaccine quacks, Mark Geier MD and his physician-imitating son David Geier. It's a pity that the editorial board squandered that good work by approving Dunkle's flight of misinformation and spin.

Critical Evaluations of deLong's A Positive Association found between Autism Prevalence and Childhood Vaccination uptake across the U.S. Population. Journal of Toxicology and Environmental Health, Part A. 2011 74(14):903-916

Sunday, July 10, 2011

Today was ScholarBoy1's (my oldest grandson) 3rd birthday party, which was a wild success. His British maternal grandparents were there, huzzah! -- I do so like them both.

The rule of thumb is "one guest per year of age", which was broken with abandon --there were about 13 kids.

Here's what made it work --

It was held at a local 1/8 scale model railway layout, so there was some exciting (but sitting with parents or other adults) time riding the rails

There were lots of other things to do, like crafts in the shade, rocks to stir, and an empty road on which to run run run, if you didn't want to ride the rails

There were approximately 2.5 adults per 3 year old

The party lasted from 11 am to 1 pm, with a lunch interlude at about 12:15.

The cake was the last bit

I really enjoyed meeting ScholarManPhD and ScholarWomanPhD's friends. It was also fascinating to watch the social and physical differences in development of a big passel of kids, all around the same age.

The owie update -- well, on flat ground (like pavement) I'm walking pretty normally. Yesterday I walked around 3 miles total, in two goes. Today, around the railroad, I was limping pretty much, but sitting on the railcars didn't hurt at all.

The deal is though that my endurance is pretty poor. I can't tell though if it was from having grandmotherly eyes all over, looking for kids about to hurt themselves, or from standing and walking for most of four hours (the pre--party set-up and the clean-up), but I was completely knackered by the time I got into the car to go home.

Saturday, July 09, 2011

But Dante lived before the era of modern science. I thought I'd update his scheme to explain what happens to those guilty of various scientific sins, ranging from the commonplace to the shocking.

Bear in mind that Dante's Hell had a place for everyone, and it was only Christ's intervention that saved anyone from it; even "good" people went to Hell because everyone sins. But they are still sins. Likewise, very few scientists (and I'm certainly not one of them) would be able to avoid being condemned to some level of this Inferno... but, that's no excuse.

Two sample (and adjacent) circles

Second Circle:

Overselling "This circle is reserved for those who exaggerated the importantance of their work in order to get grants or write better papers. Sinners are trapped in a huge pit, neck-deep in horrible sludge. Each sinner is provided with the single rung of a ladder, labelled 'The Way Out - Scientists Crack Problem of Second Circle of Hell"

Third Circle:

Post-Hoc Storytelling "Sinners condemned to this circle must constantly dodge the attacks of demons armed with bows and arrows, firing more or less at random. Every time someone is hit in some part of their body, the demon proceeds to explain at enormous length how they were aiming for that exact spot all along."

I'm thinking it could be like Rule 14 (for trolls) or the joke about joking -- the jokes are so well-known, they are referred to be numbers. A noob essays "18!" to dead silence...."It's all in the delivery, man."